Different Shades of Blue

To Emily Dickinson, it was “fixed melancholy.” To essayist George Santayana, it was “rage spread thin.” The turns of phrase conjure different emotions, but these two writers were describing the same disorder: depression. The variance is more than a matter of literary or philosophical differences; it also reflects the fact that one was a woman, the other a man.

Therapists have long known that men and women experience mental illness differently. Yet when clinicians designed the Diagnostic and Statistical Manual of Mental Disorders, the guidebook they use to diagnose psychiatric maladies, they purposely made the disease descriptions gender-neutral. Today evidence is mounting that in turning a blind eye to gender, clinicians are doing their patients a disservice. In fact, as more researchers investigate sex differences in depression and other mental illnesses, the inescapable conclusion is that gender influences every aspect of these disorders—from the symptoms patients experience to their response to medication to the course of a disorder throughout a person’s life.